Treatment

The objectives of targeted treatment of vascular dementia include symptomatic improvement of core symptoms (e.g. cognitive, behavioural), slowing progression of the disorder, and treatment of secondary factors affecting cognition (e.g. depression, anxiety, agitation).

A number of drugs have been studied in the symptomatic treatment of vascular dementia including cerebro- and vasoactive drugs, nootropics, and some calcium antagonists, but largely these studies have shown negative results.(78) Studies on symptomatic improvement in vascular dementia have mostly had small numbers, short treatment periods, variations in diagnostic criteria and tools, mixed populations, and have had variation in clinical endpoints applied.

Recently nimodipine,(79> memantine,(89 and propentofylline(81) have raised expectations for a symptomatic treatment of vascular dementia. A number of phase 3 double-blind randomized placebo-controlled trials in patients with vascular dementia using these compounds are in progress. (82>

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